| National Provider Identifier [NPI]: | 1164419008 |
| Last Name Of The Provider | BOTTESI |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 45634 SCHOENHERR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHELBY TOWNSHIP |
| Zip Code Of The Provider | 483156024 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 5478 |
| Number Of Medicare Beneficiaries | 1075 |
| Total Submitted Charge Amount | 743075 |
| Total Medicare Allowed Amount | 529604.7 |
| Total Medicare Payment Amount | 400233.4 |
| Total Medicare Standardized Payment Amount | 389202.9 |
| Drug Suppress Indicator | * |
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| Number Of Medicare Beneficiaries With Drug Services | |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
| Total Medical Submitted Charge Amount | |
| Total Medical Medicare Allowed Amount | |
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| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 199 |
| Number Of Beneficiaries Age 65 to 74 | 337 |
| Number Of Beneficiaries Age 75 to 84 | 305 |
| Number Of Beneficiaries Age Greater 84 | 234 |
| Number Of Female Beneficiaries | 621 |
| Number Of Male Beneficiaries | 454 |
| Number Of Non Hispanic White Beneficiaries | 970 |
| Number Of Black or African American Beneficiaries | 72 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 835 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 240 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 25 |
| Average HCC Risk Score Of Beneficiaries | 1.935 |